As primary and community care look set to play an even bigger role in the future of the NHS, do we know what changes we can expect, how these changes will be delivered and how they will affect the way we work?
The 2015 NMC Code of Conduct promotes four key themes: prioritising people; practising effectively; preserving safety; and promoting professionalism and trust. Each of these four themes is designed to help nurses embody the Code, but if they are to adhere to it fully, a clear understanding of the duty of candour is essential, particularly when applied to nursing practice.
Research from national charity Contact the Elderly has found that nine out of 10 people feel concerned for a lonely older person within their community or neighbourhood, while four in 10 people do not feel they can offer appropriate help to older people who might be lonely or isolated.
Venous leg ulceration can be a chronic problem that has a negative effect on patients’ quality of life and is very expensive in terms of healthcare resources. The scale of the problem is continually increasing due to the ageing population, however, the standard of care across the UK varies despite a clear relationship between accurate assessment of the patient and the delivery of effective compression therapy. One of the major obstacles to the delivery of effective treatment is the reluctance of some patients to concord with prescribed compression therapy and there are a variety of reasons for this, including a lack of patient understanding of the importance of compression, or clinicians’ lack of knowledge or experience leading to poor patient education. The authors suggest, however, that maintaining patient concordance with compression therapy can result in effective healing. Central to this is the development of an effective therapeutic relationship between the clinicians and the patient and their family/carers and this article provides an overview of how one team of nurses were able to achieve this.
This study explored district nursing teams’ perceptions of the current chronic conditions management model in a specific locality in Wales. Chronic diseases are now the leading cause of illness and disability across the UK, placing an increasing demand on public services as healthcare staff try to meet the needs of those with long-term conditions. The author used action research to conduct the study, encouraging the nurse participants to critically review their practice. The findings indicated that a major overhaul of the current model of care was not required; the foundations were there and just some small steps and a shared vision led to sustainable changes for an efficient and effective chronic conditions service.
I started my career as a student in 1996. After qualifying I took a staff nurse position in a large nursing home, before joining Caritas Services in 2007, where I continue to work to this day. I initially took a staff nurse position at one of the Caritas homes where we support adults with learning disabilities and dual diagnosis, later taking up a deputy home manager role.
In the course of their work, community nurses may often come across patients being treated with oxygen therapy for long-term conditions. This article examines the knowledge that community nurses need to provide effective evidence-based care, particularly referencing the British Thoracic Society (BTS) guidelines as well as how referral to specialist respiratory/oxygen teams can sometimes be the best option. The author also considers the potential benefits of providing community teams with pulse oximeters and how this would support them in assessing patients who might require oxygen therapy, identify at-risk patients and support clinical decision-making, particularly with referrals into specialist services.
Dysphagia is a swallowing condition that mainly affects older adults and which can be a short- or long-term issue. Dysphagia can have an enormous impact on patients and their carers and for community nurses, early identification is key to managing the condition successfully. Similarly, by familiarising themselves with the signs and symptoms of the condition, nurses can ensure prompt referral to a speech and language therapist who can formulate an individualised plan of care. Managing dysphagia requires a multidisciplinary approach, with the aim of helping patients to maintain an adequate and safe oral intake.
Interstitial cystitis or painful bladder syndrome (IC/PBS) is a chronic condition presenting with symptoms including pain, urinary urgency and urinary frequency. IC/PBS is often poorly diagnosed and many patients may have seen multiple healthcare professionals over a period of years and undergone a variety of unsuccessful treatments. The lack of a definitive definition of IC/ PBS and diagnosis of its aetiology, cause and successful treatment contributes to a poor quality of life for many patients. This article looks at the main symptoms, diagnostic techniques and treatments for the IC/PBS. The author outlines how comprehensive history taking, physical examination and appropriate clinical tests all help community nurses to arrive at an appropriate and timely diagnosis, which, when combined with individualised treatment plans, can offer patients effective relief of their symptoms.
